Wilms' tumor: Difference between revisions
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**Avoid vigorous palpation to prevent capsular rupture | **Avoid vigorous palpation to prevent capsular rupture | ||
*Patient often appears well | *Patient often appears well | ||
*Less frequent features include [[abdominal pain (peds)|abdominal pain]], [[hematuria (peds)|hematuria]], [[fever (Peds)|fever]], anorexia, [[nausea and vomiting (peds)|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Neuroblastoma]] | *[[neuroblastoma (peds)|Neuroblastoma]] | ||
==Evaluation== | ==Evaluation== | ||
*Ultrasound or CT | *[[ultrasound: Abdomen|Ultrasound]] or CT | ||
*CBC, chemistry, | *CBC, chemistry, [[LFTs]], coags | ||
==Management== | ==Management== | ||
*Consult oncology/surgery | |||
*Surgery, chemo, and/or radiation | |||
==Disposition== | ==Disposition== |
Revision as of 19:34, 1 October 2019
Background
- Affects children <10yr
- Arises from persistent embryonal renal cells
- 10-15% will have mets at presentation (lungs)
Clinical Features
- Abdominal swelling/mass
- Avoid vigorous palpation to prevent capsular rupture
- Patient often appears well
- Less frequent features include abdominal pain, hematuria, fever, anorexia, nausea/vomiting, hypertension[1]
Differential Diagnosis
Evaluation
- Ultrasound or CT
- CBC, chemistry, LFTs, coags
Management
- Consult oncology/surgery
- Surgery, chemo, and/or radiation
Disposition
- Admission